title: Development of subsequent bloodstream infection in patients with positive Hickman catheter blood cultures and negative peripheral blood cultures.
abstract: There are limited data on the incidence of subsequent bloodstream infection (BSI) and the effect of systemic antibiotics in patients who had positive catheter-drawn blood cultures (CBC) and negative peripheral blood cultures (PBC). We retrospectively reviewed all paired blood cultures from patients with Hickman catheter in the hematology-oncology ward between January 1997 and December 2008. There were 112 episodes with positive CBC and negative PBC. Nine episodes (8.0%; 95% CI, 3.0-13.1%) led to subsequent BSI within 28 days. Subsequent BSI developed in 6 of 31 episodes (19%) where empiric antibiotics were inappropriate but in 3 of 81 episodes (4%) where empiric antibiotics were appropriate (P = 0.01). Subsequent candidemia (50%, 2 of 4) was more common than subsequent bacteremia (6%, 7 of 108) (P = 0.03). In conclusion, for patients with positive CBC and negative PBC, the overall incidence of subsequent BSI was 8.0%, and inappropriate empiric antibiotics was associated with subsequent BSI.
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Oh-Hyun
authors.initials: OH
authors.lastname: Cho
authors.forename: Sang-Oh
authors.initials: SO
authors.lastname: Lee
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
authors.forename: Dae-Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: Dae Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Sung-Han
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology*; D001769:Blood / Q000382:microbiology*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002408:Catheters, Indwelling / Q000382:microbiology*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents